Report from SIR: Carotid stenting improves cognition

A study by private practice researchers found that carotid artery stenting can improve the thought process and memory skills even in patients without clear symptoms of stenosis.

The study presented last week at the 2006 Society of Interventional Radiology meeting in Toronto validates two other studies published recently by investigators in the U.S. and Germany.

Carotid artery stenting has become a widely accepted procedure for stroke prevention in high-risk patients. What researchers didn't know is that blood flow improvement after stenting also seems to make people's brains work better, said principal investigator Dr. Rodney D. Raabe, director of interventional radiology at the Inland Vascular Institute of Spokane, WA.

"Patients' memory and other cognitive functions improved. Some of them even say they see colors brighter," Raabe said.

Raabe and colleagues have prospectively assessed 51 symptomatic and asymptomatic patients treated with carotid artery stenting. The patients underwent five neurocognitive function tests that assess memory, attention, and depression at least one day before and one or two days after treatment. The study protocol provides for additional cognitive follow-up at three, six, and 12 months.

To date, 39 and 30 patients have completed three-month and six-month follow-ups, respectively. All patients underwent diagnostic angiography before and diffusion-weighted MRI after stenting. Findings show that patients with narrowed carotid arteries had neurocognitive deficits involving memory and other cognitive functions. These deficits improved after carotid artery stenting.

Stroke prevention remains the sole indication for treatment with carotid artery stenting. The accumulating new evidence suggests the potential neurocognitive benefit should be considered in future studies.

"These findings could potentially change the way carotid disease is treated in the U.S. and Europe," Raabe said.